Senate drug pricing bill may not apply to those with job-based insurance

Senate Democrats’ bill aimed at lowering prescription drug prices may not apply to the millions of people who get health insurance through their jobs, Senate aides and lobbyists say, prompting alarm from employers and progressive groups.

Democrats’ signature drug pricing measure, set to be included in their coming $3.5 trillion package, would allow the secretary of Health and Human Services to negotiate lower drug prices, a long-held Democratic goal. The House measure would apply those lower negotiated prices not only to seniors on Medicare, but also to the roughly 150 million Americans who get health insurance through their employers.

The problem: Byrd rule! In the Senate, the push is running into an obstacle from the complicated rules in the upper chamber. The “Byrd rule” requires that provisions have a sufficient impact on the federal budget. Lowering drug prices for people with private insurance does not have as direct of an impact on the federal budget as lowering prices with Medicare.

Also: Politics. In addition to Senate rules, Senate Finance Committee Chairman Ron Wyden is also navigating delicate politics as he tries to find a balance between moderate and progressive Democrats in a 50-50 Senate — the party cannot lose a single vote on the measure.

Some Democrats, including Sen. Robert Menendez (D-N.J.), are wary of cracking down too hard on the pharmaceutical industry.